Presentation
Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication. [ncbi.nlm.nih.gov]
Female Demographics and Presentation Table 2. Male Demographics and Presentation Careful physical examination confirmed the diagnosis in all the cases. Typically the perineum was raw and irritated. [pediatrics.aappublications.org]
On perineal examination, an anocutaneous fistula with meconium was present between the scrotum and well-formed anal pit [Figure 1]. Erect abdominal X-ray revealed pneumoperitoneum [Figure 2]. [jcnonweb.com]
Although, female ARM and male children with low ARM may present late, almost all male patients with high ARM present within first few days of life. [atmph.org]
Entire Body System
- Plethora
The plethora of anomalies described makes it a complex subject for embryological explanations. [ncbi.nlm.nih.gov]
Treatment
The results of the conservative treatment were comparable with that of the surgical treatment. Here, we presented the case of a 55-year-old man. Megarectosigmoids have been rarely documented in patients of this age. [e-fjs.org]
Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication. [ncbi.nlm.nih.gov]
The ultimate judgement regarding a particular clinical procedure or treatment must be made by the clinician in the light of the clinical data presented by the patient and the diagnostic or treatment options available. [uhs.nhs.uk]
Anorectal Malformations in Children: Embryology, Diagnosis, Surgical Treatment, Follow-up. Springer. pp. 31–48. doi : 10.1007/978-3-540-31751-7_3. [en.wikipedia.org]
Prognosis
Patients with this defect have all the necessary elements to be continent and have an excellent functional prognosis. [slideplayer.com]
Of the patients, 83% showed good prognosis and 15% had fair and poor prognosis. Our findings are similar. In the study of Hassink, there was a positive correlation between prognosis improvement and increasing age 15. [journals.lww.com]
These studies help to establish initial treatment and prognosis. How is ARM treated? All children with an ARM need at least one operation called an anorectoplasty or “pull-through”. [chp.edu]
Nonetheless, the prognosis of affected patients is far from excellent, as some degree of constipation is a frequent complaint in the long-term follow-up. Constipation in "low" ARM has been reported in 42%-70% of cases. [ncbi.nlm.nih.gov]
Pathological Findings: None Final Diagnosis: Anorectal Malformation (Low) Follow-up and Prognosis: The patient had an uncomplicated post-operative course. [virtualpediatrichospital.org]
Etiology
2016/5/4/274/194177 Introduction Neonatal colonic perforations are rare and even rarer are those which complicate anorectal malformations (ARMs). [1], [2] The commonly described etiologies of colonic perforations are intestinal atresias, Hirschsprung's [jcnonweb.com]
Vascular accidents occurring in utero are most commonly implicated in the etiology of CA; whereas, the etiology of ARM is widely considered multifactorial and may include participation of recessive genes (Nazer et al. 2000 ;Mo et al. 2001 ;Shinha et al [springerplus.springeropen.com]
Head Trauma 234 Sepsis and Septic Shock 242 Nonpolio Enteroviruses 332 Respiratory Syncytial Virus 334 Rhinoviruses 336 Roseola and Human Herpesviruses 337 Rubella 338 Rubeola 339 VaricellaZoster Virus 342 Viral Gastroenteritis 344 Disorders of Unknown Etiology [books.google.com]
Two lateral folds of cloacal tissue join the urorectal septum to complete the separation of the urinary and rectal tracts. 4 5 Imperforate anus Includes agenesis and atresia of the rectum and anus Etiology: unknown Incidence: 1 in 4,500 SEX: 60% male [slideplayer.com]
Anorectal malformation: the etiological factors; Pediatr Surg Int. 2015; 31:795–804 25.Wong EH, Ng C-L, Lui VC, So MT, Cherny SS, Sham PC et al. PLoS One. 2013; 1;8(8): e69142 26.Falcone RA Jr, Levitt MA, Pena A, Bates M. [jpss.eu]
Epidemiology
"Genetics, Pathogenesis and Epidemiology of Anorectal Malformations and Caudal Regression Syndrome". In Holschneider, Alexander Matthias; Hutson, John M. (eds.). [en.wikipedia.org]
Springer, Berlin Heidelberg New York, pp 3–15 Google Scholar Harris J, Källén B, Robert E (1995) Descriptive Epidemiology of Alimentary Tract Atresia. [link.springer.com]
Epidemiology: Anorectal malformations (ARM) occurs in 1 baby in every 5,000 live births. It is equally seen in boys and girls. Figure 1: Picture of a baby's bottom without an anal opening. Picture courtesy of MJArca 11/2016. [eapsa.org]
Anal atresia, vertebral, genital and urinary tract anomalies: A primary polytopic developmental field defect identified through an epidemiological analysis of associations. Am J Med Genet 2000;13:95(2):169-73. 10. [pjms.com.pk]
[…] defects were seen less commonly in our patients. [1], [2], [17] Postoperative wound infection occurred in 3% of the patients, major source being contamination during colostomy as reported by others also. [7], [10], [18] This report gives an outline of the epidemiological [jiaps.com]
Pathophysiology
[…] surgery for low ARM can be done at the same time. [1] The overall mortality of perforated ARM is 19%. [1] Sepsis and disseminated intravascular coagulation were frequent causes of death. [1] Early diagnosis of ARM in neonates, better understanding of the pathophysiology [jcnonweb.com]
It is likely that other pathophysiological “triggers” tip the balance in favour of heavy soiling. Rapid colonic transit may be one such trigger. [intechopen.com]
Keywords: constipation, paediatric colorectal, Hirschsprung disease, anorectal malformation, VACTERL Hirschsprungs disease Definition and pathophysiology Hirschprungs disease (HD) is a congenital condition characterised by the absence of ganglion cells [jpss.eu]
Prevention
Early presentation and prompt treatment of anorectal malformations is important to prevent such potential life threatening complication. [ncbi.nlm.nih.gov]
This should be preventable by passing the dilator daily for the first few months of life. In the longer term constipation may be a problem but this can usually be managed by diet or medication. [uhs.nhs.uk]
In this case anal dilation will be all that’s necessary and surgery can be prevented, unless the anus is in the wrong place. [pullthrough.org]
Thus, the posterior muscle complex surrounds the rectum and helps prevent rectal prolapse. [22] (See the images below.) Operative view of posterior sagittal anoplasty in newborn with rectoperineal fistula. [emedicine.medscape.com]
We provide a Bowel Management Program, where we work closely with you and your child to assess function and provide a way for your child to stay clean of stool and prevent accidents. Learn More > [intermountainhealthcare.org]